Can I survive renal carcinoma w/out surgery age 74 (Stage 1) Help

I was also born in 1943, but had the surgery 15 years ago.  Without surgery  at some point down the road it is likely to spread. With surgery their is always a risk because of your age. With watch and wait your chances for a sucessful surgery get harder as you get older. Get the second opinion and good luck with whatever choice you make.

Icemantoo

I think there are types of kidney cancer that they do the wait-and-watch. If you want an opinion apart from a surgeon, see a medical oncologist specializing in RCC. They have no bone in the surgery decision and they treat and study metastatic disease. I know that NIH has studied genetic kidney cancer and that certain types are very slow growing and that in patients with those types they don't do surgeries anymore. However, most of us don't have that type of kidney cancer.

See a medical oncologist that does research on RCC. If you need help finding one, post here and tell us where you are and we can help refer you to somebody.

In Los Angeles, Dr. Figlin at Cedars, Dr. Pal at City of Hope, Dr. Quinn at USC. There are others at UCLA, but I don't know them. These are just the ones I've interacted with. They all specialize in RCC and are medical oncologists.

Usually they recommend a partial nephrectomy if possible to spare kidney function, or a nephrectomy. I believe it's still the first choice, because it's been shown to reduce the likelihood of it coming back/recurring or prolong your disease-free recovery. In Stage I cases, it cures somewhere around 90-95%. However, you are potentially Stage 1, but you are near Stage 2 (the cutoff is 7 cm), and even Stage 1 can really be Stage 3 depending on where the cancer has invaded in the kidney. Chances of it spreading increase with Stage and with Grade (how abnormal the cancer is). Unfortunately, they can't tell you the stage or grade really for sure without removing it and having a pathologist examine it under a miscroscope.

Best of luck to you.

Todd

P.S. From imaging they cannot tell if it's cancer or not, what type, and definitely cannot accurately tell you the stage and grade. For that they need the thing sliced up under a miscroscope. Your Stage 1 diagnosis (if it's even cancer, as you mentioned, there's a 10% chance it's not) is a guess based on the imaging. Imaging is not very accurate. To tell the difference between Stage 1, 2 and 3 they need accurate measurement of the size on all sides, plus they need to see what kind of tissue it grew into. They can only do this accurately under a miscroscope.

You might want to talk to your doctors about the various ablation techniques that are becoming a little more mainstream these days.  Cryo-ablation (killing the tumor by freezing) and RF (radio-frequency) ablation (killing the tumor by cooking it) are being used in some cases where patients are not able to withstand surgery.  They have a slightly lower success rate (my doctor said it was about 90% whereas surgery had more of a 99% success rate for my 1.7cm lesion).  Because of my overall health (excellent other than the RCC) and the size of the lesion (as I said, 1.7cm), my doctor advised a robotic assisted partial that I had last year. At least at the time I looked into the ablation techniques, they were generally limited to lesions 4cm or smaller.  But given the way medical science is progressing, particularly in the cancer field, it might be worth a chat with your doctor.

In terms of the watch and wait, again, the size of the mass argues against doing that.  I was originally diagnosed in December, 2013 and, at the time, my little guy was estimated to be 1.5cm.  The urologist I was referred to at Stanford Hospital recommended watch and wait.  I was concerned about it potentially growing and spreading, but he told me that lesions that size typically grow very slowly.  He said that so long as it was under 4cm, it was considered Stage 1.  So I waited and it wasn't until April, 2017 that an ultrasound determined that the little bugger had grown to 1.7cm, so at that time, since there was positive growth, he recommended getting it out, which I did in June, 2017.

If you're in the Bay Area, the urologists at Stanford are all top notch.  I saw Dr. Gill and he was very thorough and a very kind, caring man.

Yeah Neprectomy is tough! So is dying I'm told. Here's a little exercise for you to do. Take a ruler that has Cm on it and draw your tumor size on a piece of paper. Then get a typical Kidney size from the internet and draw this on the same paper. When you see how big your tumor is you may change your mind. BTW waiting is BAD! The bigger your tumor gets, the prognosis worsens ALOT! I would probably get a PET scan to see if you have any cancer spread first. If you have cancer spread maybe you can keep your tumor. Gee what if you were healthy otherwise and lived to be 95? Take the shot at living longer, make sure you have some good Doctors and work with a recognized Cancer hospital!

Haven't seen any updated posts. Surgery or no surgery? My mom was diagnosed at age 79. She had robotic surgery and was home 5 days later after her kidney was removed. I hope you have given this serious thought. The longer you wait the chance it will spread. If you have it removed it can possibly be a cure. Either way, let us know how you are. We care. All the best to you.